Wonder how much is widespread and how many are
merely a few black sheep.

How Indian Doctors Loot
Patients.

Most of
these observations are either completely or partially true. Corruption has many
names, and one of civil society isn't innocent either. Professionals and
businessmen of various sorts indulge in unscrupulous practices. I recently had
a chat with some doctors, surgeons and owners of nursing homes about
the tricks of their trade. Here is what they said

1)
40-60% kickbacks for lab tests. When a doctor (whether family doctor /
general physician, consultant or surgeon) prescribes tests - pathology,
radiology, X-rays, MRIs etc. - the laboratory conducting those tests gives
commissions. In South and Central Mumbai --
40%. In the suburbs north of Bandra -- a whopping 60 per cent! He probably
earns a lot more in this way thanthe consulting fees that you pay.

2) 30-40% for
referring to consultants, specialists & surgeons. When your friendly GP
refers you to a specialist or surgeon, he gets 30-40%.

3) 30-40% of total
hospital charges. If the GP or consultant recommends hospitalization, he
will receive kickback from the private nursing home as a percentage of all
charges including ICU, bed, nursing care, surgery.

4) Sink tests. Some
tests prescribed by doctors are not needed. They are there to inflate bills and
commissions. The pathology lab understands what is unnecessary. These are
called "sink tests"; blood, urine, stool samples collected will be
thrown.

5) Admitting the
patient to "keep him under observation". People go to
cardiologists feeling unwell and anxious. Most of them aren't really having a
heart attack, and cardiologists and family doctors are well aware of this. They
admit such safe patients, put them on a saline drip with mild sedation, and
send them home after 3-4 days after charging them a fat amount for ICU, bed
charges, visiting doctors fees.

6) ICU minus
intensive care. Nursing homes all over the suburbs are run by doctor
couples or as one-man-shows. In such places, nurses and ward boys are 10th
class drop-outs in ill-fitting uniforms and bare feet. These "nurses"
sit at the reception counter, give injections and saline drips, perform ECGs,
apply dressings and change bandages, and assist in the operation theatre. At
night, they even sit outside the Intensive Care Units; there is no resident
doctor. In case of a crisis, the doctor -- who usually lives in the same
building -- will turn up after 20 minutes, after this nurse calls him. Such
ICUs admit safe patients to fill up beds. Genuine patients who require
emergency care are sent elsewhere to hospitals having a Resident Medical
Officer (RMO) round-the-clock.

7) Unnecessary
caesarean surgeries and hysterectomies. Many surgical procedures are done
to keep the cash register ringing. Caesarean deliveries and hysterectomy
(removal of uterus) are high on the list. While the woman with labour -pains is
screaming and panicking, the obstetrician who gently suggests that caesarean is
best seems like an angel sent by God! Menopausal women experience bodily
changes that make them nervous and gullible. They can be frightened by words
like " and "fibroids" that are in almost every normal woman's
radiology reports. When a gynaecologist gently suggests womb removal "as a
precaution", most women and their husbands agree without a second's
thought.

8) Cosmetic surgery
advertized through newspapers. Liposuction and plastic surgery are not
minor procedures. Some are life-threateningly major. But advertisements make
them appear as easy as facials and waxing. The Indian medical councilhas strict rules against such misrepresentation.
But nobody is interested in taking action.

9)
Indirect kickbacks from doctors to prestigious hospitals. To be on the
panel of a prestigious hospital, there is give-and-take involved. The hospital
expects the doctor to refer many patients for hospital admission. If he fails
to send a certain number of patients, he is quietly dumped. And so he likes to
admit patients even when there is no need.

10) "Emergency surgery" on
dead body. If a surgeon hurriedly wheels your patient from the Intensive
Care Unit to the operation theatre, refuses to let you go inside and see him,
and wants your signature on the consent form for "an emergencyoperation to save his life", it is likely
that your patient is already dead. The "emergency operation" is for
inflating the bill; if you agree for it, the surgeon will come out 15 minutes
later and report that your patient died on the operation table. And then, when
you take delivery of the dead body, you will pay OT
charges, anaesthesiologist's charges, blah-blah-

Doctors are humans too. You can't trust them
blindly. Please understand the difference.

Young surgeons and old ones. The young ones who are setting up nursing home etc. have heavy
loans to settle. To pay back the loan, they have to perform as many operations
as possible. Also, to build a reputation, they have to perform a large number
of operations and develop their skills. So, at first, every case seems fit for
cutting. But with age, experience and prosperity, many surgeons lose their
taste for cutting, and stop recommending operations.

Physicians and surgeons. To a man with a hammer, every problem looks like a nail. Surgeons
like to solve medical problems by cutting, just as physicians first seek
solutions with drugs. So, if you take your medical problem to a surgeon first,
the chances are that you will unnecessarily end up on the operation table.
Instead, please go to an ordinary GP first

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